Listen Now

In this episode of Cracking Addiction, we are again joined by addiction psychiatrist Dr Dan Pham and discuss how to take a trauma history without further traumatising or triggering a patient. We also discuss the diagnostic criteria for PTSD and how to formulate this condition. In this episode, we discuss trauma-informed care and how to treat and manage trauma and PTSD, and what psychological and medical therapies may be useful to manage this condition, and briefly touch on some of the emerging research surrounding psychedelic-assisted psychotherapy in PTSD. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle. Latest Blogs https://www.meducate.com.au/blog About Meducate ® Meducate provides online education for doctors, clinicians, health professionals and the public. See the website to browse the many different talks and courses available https://www.meducate.com.au

In the episode of Cracking Addiction, we are joined by Dr Daniel Pham an Addiction Psychiatrist working at Turning Point who discusses with us the differences and similarities between Addiction Medicine and Addiction Psychiatry. We discuss the term dual diagnosis and the interplay between mental health and substance use disorders. This episode focuses mainly on trauma, PTSD and its interplay with substance use disorders and we discuss how trauma occurs and how to diagnose trauma and PTSD. We also explore integrated care and how to manage patients with co-occurring trauma or PTSD and substance use disorders and we touch on trauma informed care and how to approach taking a trauma history. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle. Latest Blogs https://www.meducate.com.au/blog About Meducate ® Meducate provides online education for doctors, clinicians, health professionals and the public. See the website to browse the many different talks and courses available https://www.meducate.com.au

Join us in this episode as we hear from Dr. Tony Weeks, a former Director of Anaesthesia at Alfred Health, as he shares his experiences in treating doctors with addiction and working in a medically supervised injecting room. Dr. Weeks speaks candidly about the challenges of helping colleagues with substance use disorders, and the complexities of treating doctors who are also struggling with addiction. After retiring from his work as an anesthetist, Dr. Weeks volunteered at a drug consumption room in North Richmond, Melbourne, where he helped patients find veins to inject into, assisted those who overdosed, and provided opioid substitution therapy. Through his vast and varied career, Dr. Weeks has seen firsthand the life-saving work that takes place in drug consumption rooms. He shares his insights on the evidence-based nature of harm reduction interventions, such as drug consumption rooms, and the importance of treating addiction as a public health issue. Don't miss this thought-provoking conversation with Dr. Tony Weeks, where he sheds light on the challenges and rewards of helping those struggling with addiction, including colleagues and fellow doctors. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle. Latest Blogs https://www.meducate.com.au/blog About Meducate ® Meducate provides online education for doctors, clinicians, health professionals and the public. See the website to browse the many different talks and courses available https://www.meducate.com.au

This week on Cracking Addiction we talk with Psycologist and Author Dr Laura Petracek. We explore the principles of Dialectical Behavior Therapy (DBT) and how they can be applied to the 12 Steps of addiction recovery. Recovering from addiction and managing a mental illness can be challenging and often feels like they take over your life. However, with the right tools and strategies, you can regulate your emotions, develop self-management skills, reduce anxiety and stress, and feel like yourself again. DBT is a type of talking therapy that is specifically tailored to individuals who feel emotions very intensely. Her workbook takes the skills and strategies drawn from DBT and applies them to each of the 12 Steps of addiction recovery. This new roadmap helps reduce emotional distress symptoms, supports sobriety, and promotes overall mental health. By exploring the connection between DBT and the 12 Steps, this workbook equips you with the tools to manage your emotions and navigate your journey to recovery. If you're looking for a practical and effective approach to manage your mental health while recovering from addiction, this workbook is the perfect resource for you. Discussions and comments in our videos are for informational purposes only and should not replace the advice of a qualified medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle. Latest Blogs https://www.meducate.com.au/blog About Meducate ® Meducate provides online education for doctors, clinicians, health professionals and the public. See the website to browse the many different talks and courses available https://www.meducate.com.au

Join us in this informative episode as we dive into the topic of urine drug tests in Addiction Medicine. We will discuss the purpose and importance of these tests and the circumstances in which they are performed. We will also touch on the key indications that may lead to a urine drug screen being administered during addiction treatment. Patients can often have concerns and feel stigma surrounding urine drug testing. We will address these issues and offer ways to mitigate any negative feelings that may arise. Additionally, we will provide guidance on how to interpret the results of a urine drug screen, including what they mean and what actions can be taken based on the results. Whether you are a healthcare provider, a patient, or simply curious about this topic, this show is a must-listen. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle. Latest Blogs https://www.meducate.com.au/blog About Meducate ® Meducate provides online education for doctors, clinicians, health professionals and the public. See the website to browse the many different talks and courses available https://www.meducate.com.au

In this episode, the focus is on the complicated issue of "takeaway doses" in opioid substitution therapy. Opioid substitution therapy is a treatment program that aims to help people overcome opioid addiction by substituting their drug of abuse with a safer and more controlled opioid, such as methadone or buprenorphine. One aspect of opioid substitution therapy is the use of "takeaway doses." This refers to the provision of extra doses of the opioid substitute to patients, which they can take away from the clinic for later use in case of emergency or unexpected circumstances. However, the use of take away doses raises several concerns from a clinical safety perspective, as there is always a risk of patients misusing or diverting the extra medication. In this episode of "Cracking Addiction," the topic of take away doses is thoroughly explored, with a focus on balancing the clinical safety concerns with the needs and requirements of patients. The criteria for takeaway doses, such as the patients' stability and progress in treatment, are discussed. Additionally, the contraindications to take away doses, such as recent drug use or a history of non-adherence, are also discussed. Finally, the show explores the patient's perspective and concerns with regards to takeaway doses. Patients may have concerns about the security and safety of their extra medication, as well as their own ability to resist the temptation to misuse it. By addressing these concerns and discussing the pros and cons of take away doses, "Cracking Addiction" aims to provide a comprehensive and balanced examination of this complex and controversial aspect of opioid substitution therapy. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle. Latest Blogs https://www.meducate.com.au/blog About Meducate ® Meducate provides online education for doctors, clinicians, health professionals and the public. See the website to browse the many different talks and courses available https://www.meducate.com.au

Inhalant Abuse: Understanding the Dangers of Hydrocarbon and Nitrite Inhalation - Hydrocarbon inhalants are substances that are inhaled for their intoxicating effects. They include a wide range of products, such as gasoline, paint thinner, glue, and aerosol sprays. These substances are commonly abused by inhaling the fumes, which can produce a feeling of euphoria and relaxation. However, inhaling hydrocarbon fumes can be extremely dangerous and can lead to a number of negative health effects, including respiratory problems, brain damage, and even death. Additionally, inhaling these substances can also be highly flammable and can lead to fires and explosions. It is important to avoid inhaling hydrocarbon fumes and to seek help if you or someone you know is struggling with addiction to these substances. Additionally we discuss nitrites which are vasodilators and can create a warm rush and sensation of warmth and also can be used as a chemsex drug which can cause anal sphincter relaxation. Side effects can include headaches, hypotension, methaemoglobinaemia and can cause burns if nititres are exposed to a flame. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle. Latest Blogs https://www.meducate.com.au/blog About Meducate ® Meducate provides online education for doctors, clinicians, health professionals and the public. See the website to browse the many different talks and courses available https://www.meducate.com.au

Medicinal Cannabis Part 2 – In this episode of Cracking Addiction, Dr. Jim Connel joins us again and we discuss the side effects of cannabis, in particular psychiatric side effects, harms that may be associated with medicinal cannabis, the current regulations with regard to driving and medicinal cannabis, the experiences in other countries where medicinal cannabis has a longer history than in Australia, predictions with regard to the future role of medicinal cannabis, and potential roles of medicinal cannabis in addiction medicine. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle. Latest Blogs https://www.meducate.com.au/blog About Meducate ® Meducate provides online education for doctors, clinicians, health professionals and the public. See the website to browse the many different talks and courses available https://www.meducate.com.au

Medicinal Cannabis Part 1– In this episode of Cracking Addiction, we are joined by Dr. Jim Connell, a GP and medicinal cannabis prescriber and the founder and chief medical officer of Heyday Medical. In this episode of Cracking Addiction, we discuss the endocannabinoid system, cannabis, and the cannabinoids that comprise cannabis, the history of medicinal cannabis, the current indications for medicinal cannabis, the evidence for cannabis for anxiety, depression, chronic pain, and sleep, and whether there is a role or any evidence for medicinal cannabis as an opioid-sparing agent, as well as how to select patients appropriately for a trial of medicinal cannabis. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle. Latest Blogs https://www.meducate.com.au/blog About Meducate ® Meducate provides online education for doctors, clinicians, health professionals and the public. See the website to browse the many different talks and courses available https://www.meducate.com.au

The distress that individuals undergoing opioid withdrawal can experience can range from mild to severe, depending on the type and duration of opioid use, as well as the individual's overall physical and mental health. Different opioids can cause slightly different withdrawal symptoms, which can include physical symptoms such as muscle aches, sweating, and insomnia, as well as psychological symptoms such as anxiety, depression, and irritability. One of the most challenging aspects of opioid withdrawal is the phenomena of precipitated withdrawal, which occurs when an individual is given a medication that binds to the same receptors as the opioid they are dependent on, which can cause an intense and sudden onset of withdrawal symptoms. Precipitated withdrawal can be incredibly distressing, and it is important for individuals to be aware of this potential outcome if they are considering using medications to help manage their withdrawal symptoms. Managing the symptoms of opioid withdrawal can be a complex process, and it is important for individuals to work with medical professionals to develop a plan that is tailored to their specific needs. This may include the use of medications such as methadone or buprenorphine to help ease withdrawal symptoms, as well as counseling and support services to address the psychological aspects of addiction. It is important to note that an isolated opioid withdrawal without a plan for using opioid substitution therapy can increase the risk of relapse and overdose. When an individual is no longer opioid tolerant post opioid withdrawal, they are at a higher risk of an overdose if they do relapse, which is why it is essential to have a plan in place for opioid substitution therapy and ongoing support for addiction recovery. In summary, opioid withdrawal is a complex and challenging process that can cause a range of physical and psychological symptoms. Precipitated withdrawal can be particularly distressing, and it is important to work with medical professionals to develop an individualized plan for managing withdrawal symptoms. Additionally, it is important to have a plan for opioid substitution therapy and ongoing support for addiction recovery to avoid the risks of relapse and opioid overdose. Opioid withdrawal is a complex phenomenon. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle. Latest Blogs https://www.meducate.com.au/blog About Meducate ® Meducate provides online education for doctors, clinicians, health professionals and the public. See the website to browse the many different talks and courses available https://www.meducate.com.au

In the 75th episode of Cracking Addiction we discuss nitrous oxide or nangs and their medical uses and indications and the use of nitrous oxide as a euphorigenic and sedative substance of abuse. We discuss the side effects and harms associated with nitrous oxide use and emphasise in particular the functional B12 deficiency that can be associated with nitrous oxide use and in particular the neurological side effects and the treatment and management options for B12 deficiency. We also discuss the harms that can occur using the cannisters in which nitrous oxide is stored and the ease of availability of nitrous oxide and its increasing usage in the adolescent population. Nitrous oxide, also known as "laughing gas," is a colorless, sweet-tasting gas that is used for a variety of medical and dental procedures. When inhaled, it can produce feelings of euphoria and relaxation. While nitrous oxide may seem harmless, it can be dangerous when used improperly or in excessive amounts. Some of the potential dangers include: Oxygen deprivation: Nitrous oxide can decrease the amount of oxygen in the body, which can lead to brain damage or even death if used in large amounts or for prolonged periods of time. Numbness and tingling: Nitrous oxide can cause numbness and tingling in the fingers, toes, and lips, which can be permanent if used excessively. Fainting or dizziness: Nitrous oxide can cause fainting or dizziness, which can be dangerous if the person falls or injures themselves. Cold burns: Nitrous oxide canisters can become very cold when used, and can cause cold burns or frostbite if they come into contact with the skin. Addiction: Nitrous oxide can be addictive, and people who use it excessively may develop a tolerance to the drug and require more to achieve the same effects. "Nangs" is a colloquial term for nitrous oxide canisters, particularly in Australia.

Cocaine toxicity - In this episode of Cracking Addiction, we discuss the metabolites of cocaine, the different organ systems affected by cocaine, and the harms associated with cocaine use. We discuss the harms of coingestion in particular of alcohol and cocaine and the toxic metabolite cocaethylene. We also discuss the common adulterants mixed in with cocaine and the harms that can be caused by these adulterants. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle. Latest Blogs https://www.meducate.com.au/blog About Meducate ® Meducate provides online education for doctors, clinicians, health professionals and the public. See the website to browse the many different talks and courses available https://www.meducate.com.au

Cocaine, Crack and Freebase -In this episode of Cracking Addiction we explore cocaine, it's origins, the difference between powder cocaine and crack and freebase and the effects of cocaine on various organ systems and in pregnancy. Cocaine is a stimulant drug that is made from the leaves of the coca plant. It is a powerful psychoactive substance that is commonly used for recreational purposes. When ingested, cocaine produces feelings of increased energy, alertness, and euphoria. It is also a potent anesthetic and can be used medically to numb tissues and decrease bleeding during surgery. Crack is a form of cocaine that has been processed to create a rock crystal, which can be smoked. Crack cocaine is highly addictive and produces a strong, immediate high that lasts for only a few minutes. The high is followed by a crash that leaves the user feeling exhausted and depressed. Freebase is another form of cocaine that has been processed to create a more pure, potent form of the drug. It is made by mixing cocaine with ammonia or sodium bicarbonate and heating the mixture to remove the hydrochloride salt, which makes the cocaine more soluble in water. This allows the drug to be smoked, producing an intense, short-lived high. Freebase cocaine is extremely potent and can be very dangerous due to the high risk of overdose. It is important to note that all forms of cocaine are potentially harmful and can have serious short-term and long-term health effects. Regular use of cocaine can lead to addiction and can have detrimental effects on mental and physical health. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle. Latest Blogs https://www.meducate.com.au/blog About Meducate ® Meducate provides online education for doctors, clinicians, health professionals and the public. See the website to browse the many different talks and courses available https://www.meducate.com.au

Dr Ferghal speaks with Dr Matthew Frei, an addiction medicine specialist who specialises in providing written reports in the field of addiction medicine. There are many agencies or entities that might request a formal opinion from an addiction medicine specialist. These include Vic Roads, insurance companies, AHPRA and the coroner’s court. When writing reports for Vic roads one must bear in mind the private and commercial driving standards. Such reports usually are requested after a patient has tested positive for a prohibited substance, or because they have tested positive for a blood alcohol concentration in excess of the legal limit (0.05%). Reports may be requested by insurance companies regarding the suitability of ongoing high dose opioid prescribing, usually in the context of chronic pain. Court reports usually are requested in the context of alleged medical error or negligence. Dr Frei’s advice to anyone considering writing a report is firstly to maintain impartiality, and secondly to be aware that the report will be scrutinised by all parties with a material interest in the matter at hand. For those starting out it is useful to bear in mind that language does not have to be literary, and that it is more important to be factually correct and fair in providing an opinion. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle. Latest Blogs https://www.meducate.com.au/blog About Meducate ® Meducate provides online education for doctors, clinicians, health professionals and the public. See the website to browse the many different talks and courses available https://www.meducate.com.au

Dr Ferghal speaks with Dr Matthew Frei, an addiction medicine specialist who specialises in the care and management of clinicians who find themselves struggling with addictions. Clinicians face significant stigma when dealing with their own illnesses, and even more so in the situation of mental illness and substance use disorder. An additional barrier to accessing treatment is the regulatory environment within which clinicians must access care. This includes the potential for mandatory reporting to AHPRA. For these reasons clinicians tend to present late for help. The good news is however that clinicians are more likely to make a recovery from addiction, in that they are, as Dr Frei states, “overrepresented in success stories”. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle. Latest Blogs https://www.meducate.com.au/blog About Meducate ® Meducate provides online education for doctors, clinicians, health professionals and the public. See the website to browse the many different talks and courses available https://www.meducate.com.au

In this episode of Cracking Addiction I speak with Associate Professor Suzanne Nielsen about the opioid epidemic and what we can do about it. In the USA there seems to be more a problem with heroin whereas in Australia we are struggling with prescription opioid dependence. Even though a doctor may be prescribing your pain killers, it is still possible to become addicted to pain killers. The traditional treatments we have for opioid dependence in general include methadone and buprenorphine based opioid replacement therapy. A recent addition to the family includes the Long -Acting Injectable Buprenorphine therapies, commonly referred to as “the Injection”. Patients who struggle with prescription opioid use disorder (which has been referred to as “pain killer addiction”) also benefit from opioid replacement therapy. Suzanne’s research over the last ten years has proven that the same therapies that work for heroin dependency, also work for prescription opioid dependency. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle. Latest Blogs https://www.meducate.com.au/blog About Meducate ® Meducate provides online education for doctors, clinicians, health professionals and the public. See the website to browse the many different talks and courses available https://www.meducate.com.au

In episode 69 of Cracking Addiction we discuss the difference and similarities between general practice and Addiction Medicine. We discuss Addiction Medicine consultation liaison services in hospital, inpatient and community management options with regards to Addiction Medicine. Lastly we discuss the role general practitioners play in managing patients with substance use disorders within the community and the breadth of community presentations and continuity of care that they provide their patients. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle. Latest Blogs https://www.meducate.com.au/blog About Meducate ® Meducate provides online education for doctors, clinicians, health professionals and the public. See the website to browse the many different talks and courses available https://www.meducate.com.au

In this episode of Cracking Addiction we discuss the class of drugs known as gabapentinoids, a group of GABA analogues. In this episode we discuss the clinical uses of gabapentinoids and also the increasing rates of prescription of gabapentinoids in recent years and the resultant harms associated with gabapentinoids including the risks of dependence/addiction as well as increased rates of overdose and polypharmacy harms. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle. Latest Blogs https://www.meducate.com.au/blog About Meducate ® Meducate provides online education for doctors, clinicians, health professionals and the public. See the website to browse the many different talks and courses available https://www.meducate.com.au

In episode 67 of Cracking Addiction we discuss the management of acute intoxication of MDMA and discuss the principles of both MDMA and stimulant withdrawal including supportive management options as well as the importance of psychosocial interventions in particular contingency management and CBT based interventions. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle. Latest Blogs https://www.meducate.com.au/blog About Meducate ® Meducate provides online education for doctors, clinicians, health professionals and the public. See the website to browse the many different talks and courses available https://www.meducate.com.au

In episode 66 of Cracking Addiction we discuss MDMA or ecstacy and discuss its analogues PMA and PMMA and discuss the pharmacokinetics of these drugs, the unique properties of MDMA as both an atypical amphetamine-type substance and its effects as an empathogen. We also discuss the usage as both a recreational drug but also the new and emerging evidence of the clinical effects and benefits of MDMA and its increased usage in medical practice. MDMA has many effects on the body and we discuss the effects of MDMA on the brain, heart and liver in particular as well as some of the side effects of MDMA. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle. Latest Blogs https://www.meducate.com.au/blog About Meducate ® Meducate provides online education for doctors, clinicians, health professionals and the public. See the website to browse the many different talks and courses available https://www.meducate.com.au